University of South Florida Morsani College of Medicine, and James A. Haley Veterans Hospital, Department of Internal Medicine and Division of Allergy and Immunology, Tampa, Florida.
University of South Florida Morsani College of Medicine, and James A. Haley Veterans Hospital, Department of Internal Medicine and Division of Allergy and Immunology, Tampa, Florida.
Ann Allergy Asthma Immunol. 2018 Sep;121(3):320-327. doi: 10.1016/j.anai.2018.03.017. Epub 2018 Mar 19.
Hepatitis B (HBV) is a viral illness that chronically infects 240 million people worldwide, leads to liver disease, and increases risk of hepatocellular carcinoma. The HBV vaccine has decreased HBV infection, and it and the human papilloma virus vaccine are the only vaccines that prevent cancer. Despite the effectiveness of the HBV vaccine, some populations do not develop protective responses. The risk groups for poor response include those with immunosuppression or dialysis-dependent, end-stage renal disease. Five percent of normal people do not have a response. These subjects are deemed HBV "nonresponders." Multiple strategies to improve the immunogenicity of the HBV vaccine are currently being pursued, including vaccine adjuvants, recombinant vaccines, and immune enhancement via up-regulation of dendritic cells.
PubMed was searched for peer-reviewed publications published from January 1980 to September 2017.
Studies retrieved for inclusion summarized potential mechanisms behind HBV vaccine nonresponsiveness and potential solutions.
The mechanisms behind HBV vaccine nonresponsiveness vary between each subject population. Many current and future strategies may provide protective immunity against HBV in each of these populations.
This review provides a background on the immunology of HBV infection, the possible immunologic mechanisms to explain HBV vaccine nonresponsiveness, current research aimed at improving vaccine effectiveness, and possible future approaches for providing nonresponders protection from HBV.
乙型肝炎病毒（HBV）是一种慢性感染全球 2.4 亿人的病毒疾病，可导致肝脏疾病，并增加肝细胞癌的风险。HBV 疫苗已减少 HBV 感染，且其与人类乳头瘤病毒疫苗是唯一可预防癌症的疫苗。尽管 HBV 疫苗有效，但某些人群无法产生保护反应。对疫苗反应差的风险群体包括免疫抑制或依赖透析、终末期肾病患者。5%的正常人无反应。这些人群被视为 HBV“无应答者”。目前正在采取多种策略来提高 HBV 疫苗的免疫原性，包括疫苗佐剂、重组疫苗以及通过上调树突状细胞来增强免疫。
PubMed 检索了 1980 年 1 月至 2017 年 9 月发表的同行评审出版物。
检索到的纳入研究总结了 HBV 疫苗无应答的潜在机制和潜在解决方案。
HBV 疫苗无应答的机制因每个受检人群而异。许多当前和未来的策略可能为这些人群提供针对 HBV 的保护性免疫。
本文综述了 HBV 感染的免疫学背景、解释 HBV 疫苗无应答的可能免疫机制、旨在提高疫苗有效性的当前研究以及为无应答者提供 HBV 保护的可能未来方法。
